Individual provider Active NPI

Yoojin Kim Pak, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Lisle, IL
National Provider Identifier
1003072877
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036127398 Issued in IL
Practice address
430 Warrenville Rd # 310
Lisle, IL 60532-1348
Phone
(630) 789-4910
Fax
(630) 432-6744
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036127398 IL Primary

Addresses

Primary practice location

430 Warrenville Rd # 310
Lisle, IL 60532-1348

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036127398MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ykim24902@direct.edward.org
Direct Messaging Address ypak24902@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130809000155 IL Practitioner - Endocrinology 3971745613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Chicago College of Medicine and Surgery, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231
  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036127398ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Sep 1, 2013 Accepting new patients
Dupage Medical Group LTD CurrentSince Sep 1, 2013 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

430 Pennsylvania Ave
#320
Glen Ellyn, IL 60137
Phone (630) 668-2180

430 Warrenville Rd
Ste 310
Lisle, IL 60532
Phone (630) 548-0408

430 Warrenville Rd
Ste 210
Lisle, IL 60532
Phone (630) 432-6180

430 Warrenville Rd
#310
Lisle, IL 60532
Phone (630) 789-4910

430 Warrenville Rd
Lisle, IL 60532
Phone (630) 432-6180

Networks

  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL PPO Downstate
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • IL HMO C-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1003072877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WARRENVILLE RD # 310",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321348",
            "telephone_number": "630-789-4910",
            "fax_number": "630-432-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "YOOJIN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036127398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036127398",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ykim24902@direct.edward.org",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd # 310",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ypak24902@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "430 Warrenville Rd # 310",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.